Community Intervention to Increase Cervical Cancer Screening-Chinese American Women
Chinese Americans comprise the largest group among the U.S. Asian population. Census 2000 data indicate that nearly three quarters of a million of the total U.S. Chinese population of 2.5 million reside in the Northeastern corridor of the country. A large subset of this group is comprised of recent immigrants. Demographic trends and distinctive characteristics of this group underscore the importance of addressing the group's needs and the design and implementation of specially adapted intervention strategies to meet their needs. Cervical cancer represents a serious health issue among Chinese women. Recent studies indicated that Chinese women are less aware of cervical cancer risk factors and showed that, in addition to a higher incidence of the disease, they experience worse survival rates post diagnosis of early stage cervical carcinoma than non-Asian groups. Although use of the of the Papanicolaou (Pap) test has placed cervical cancer in the range of most preventable cancers and has effected a dramatic drop in cervical cancer diagnoses in the general US population, disparities in incidence and mortality of this disease remain among certain minority groups, including Chinese women, where Pap test utilization rates have remained low. This study proposes to develop a culturally sensitive and linguistically appropriate intervention program for underserved and mostly uninsured Chinese women to increase their knowledge, change their attitudes and improve their cervical cancer screening rate. The study will also identify health system access barriers and form the basis for developing a future viable navigation program. The study will use two-group quasi-experimental design, with pre- and post-intervention tests and a 6-month follow up telephone call. Participants in New York City (n=100), age 40 and above, will be assigned to intervention or comparison group. The intervention group will participate in a comprehensive educational intervention program designed to increase knowledge about and attitudes regarding cervical cancer, and provided navigation assistance (appointments, language, etc.), and will participate in an open discussion with Chinese-speaking physician and community health educators. Handouts on cervical cancer and Pap test and a video, in Chinese, will also be made available to the intervention group. The control group will be provided with small group education and materials on general cancer prevention and early detection, and encouraged to visit their health providers for screening. The pilot study aims represent an extension of our NCI-funded parent CNP grant, ATECAR-Asian Community Cancer Network. The study is directly related to ATECAR goals of reducing the incidence and risk behaviors of cancer among Asian Americans, stimulating partners' participation in and increasing research and training opportunities for Asian junior investigators in cancer interventions. Findings of the study, especially on patient navigation, will lay the groundwork for a full-scale randomized intervention trial of a culturally tailored cervical cancer intervention, focused on Chinese American women.